Healthcare Provider Details

I. General information

NPI: 1437698107
Provider Name (Legal Business Name): EDWARD A CARRINGTON MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2017
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E SOUTHERN AVE STE F4
TEMPE AZ
85282-7626
US

IV. Provider business mailing address

2600 E SOUTHERN AVE STE F4
TEMPE AZ
85282-7626
US

V. Phone/Fax

Practice location:
  • Phone: 480-659-5015
  • Fax:
Mailing address:
  • Phone: 480-659-5015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number9227
License Number StateAZ

VIII. Authorized Official

Name: EDWARD CARRINGTON
Title or Position: MANAGER
Credential:
Phone: 480-659-5015